Remote patient monitoring services can be reimbursed only if the service and the provider’s protocols meet listed conditions; a health coverage plan may also require prior authorization.
§1843. Remote patient monitoring services A. The legislature hereby finds all of the following: (1) Remote patient monitoring services aim to allow more people to remain at home or in other nontraditional clinical settings and to improve the quality and cost of their care, including prevention of more costly care. (2) The goal of remote patient monitoring services provided through telehealth is to coordinate primary, acute, behavioral, and long-term social service needs for high-need, high-cost patients. B. To receive reimbursement for the delivery of remote patient monitoring services through telehealth, all of the following conditions shall be met: (1) The services shall consist of all of the following: (a) An assessment, problem identification, and evaluation which includes all of the following: (i) Assessment and monitoring of clinical data including but not limited to appropriate vital signs, pain levels, and other biometric measures specified in the plan of care and an assessment of responses to previous changes in the plan of care. (ii) Detection of condition changes based on the telehealth encounter that may indicate the need for a change in the plan of care. (b) Implementation of a management plan through one or more of the following: (i) Teaching regarding medication management as appropriate based on the telehealth findings for that encounter. (ii) Teaching regarding other interventions as appropriate to both the patient and the caregiver. (iii) Management and evaluation of the plan of care including changes in visit frequency or addition of other skilled services. (iv) Coordination of care with the ordering healthcare provider regarding the telehealth findings. (v) Coordination and referral to other healthcare providers as needed. (vi) Referral for an in-person visit or the emergency room as needed. (2) The entity that will provide the remote monitoring services shall have protocols in place to address all of the following: (a) Authentication and authorization of users. (b) A mechanism for monitoring, tracking, and responding to changes in the patient's clinical condition. (c) A standard of acceptable and unacceptable parameters for the patient's clinical parameters, which can be adjusted based on the patient's condition. (d) How monitoring staff will respond to abnormal parameters for the patient's vital signs, symptoms, or lab results. (e) The monitoring, tracking, and responding to changes in the patient's clinical condition. (f) The process for notifying the prescribing healthcare provider for significant changes in the patient's clinical signs and symptoms. (g) The prevention of unauthorized access to the system or information. (h) System security, including the integrity of information that is collected, program integrity, and system integrity. (i) Information storage, maintenance, and transmission. (j) Synchronization and verification of patient profile data. (k) Notification of the patient's discharge from the remote patient monitoring services or the deinstallation of the remote patient monitoring unit. C. A health coverage plan may require an authorization request for remote patient monitoring prior to the health coverage plan's approval of coverage for a specified healthcare service. Acts 2020, No. 276, §1, eff. Jan. 1, 2021; Acts 2023, No. 322, §1, eff. Jan. 1, 2024.